Up to $41.4 million can be used by states, caregivers and others to find new ways to prevent significant, long-term health problems for high-risk pregnant women and newborns enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).

UAB will receive up to $730,000 over the next four years.

“Perinatal outcomes, for both mothers and infants in Alabama are, unfortunately, among the worst in the country,” said Joseph Biggio, M.D., professor of medicine and chair of the UAB Division of Maternal and Fetal Medicine and the award’s principal investigator. “High rates of premature birth, obesity, diabetes, hypertension and substance abuse plague our state. The Strong Start program provides an opportunity to begin to offer services effective in improving pregnancy outcomes to women at greatest risk.”

The UAB initiative is designed to enhance the services offered at UAB clinics in and around Jefferson County, within the existing maternity care homes model used to care for Medicaid-eligible pregnant women based on their individual needs. The program will consist of various social support services including depression and substance-use screening and treatment, educational sessions on healthy behaviors and nutritional counseling for underweight and overweight pregnant women.

The UAB initiative is designed to enhance the services offered at UAB clinics in and around Jefferson County, within the existing maternity care homes model used to care for Medicaid-eligible pregnant women based on their individual needs.

According to Biggio, teachable moments occur during significant life events like pregnancy that motivate people to adopt risk-reducing health behaviors. The enhanced services provided to Strong Start participants during pregnancy provides education on lifelong health benefits associated with good nutrition and exercise, mental health support, pregnancy timing and substance avoidance.

Outcomes data, including gestational age and infant weight at delivery, will be collected and reported for all patients in the Strong Start program. Historical data on births at least two years prior to the intervention will also be provided. Findings will help construct a program to enhance current services to Medicaid and CHIP-eligible patients that promote healthy living, as well as reduce poor pregnancy outcomes, specifically preterm births.

“The Strong Start initiative will help find ways to reduce the rate of preterm births, which is a public health problem with significant long-term consequences for families and children,” Sebelius said.

More than half a million infants are born prematurely in America each year. Costs associated with preterm births are around $26 billion a year. Children born preterm require costly medical attention, and they often require early-intervention services and special education. They can develop conditions that may affect their health and productivity as adults.

“As a nurse and a mother, I know there is nothing more important for a child than getting off to a healthy start,” said CMS Acting Administrator Marilyn Tavenner. “We are excited to be partnering with health care providers and community organizations across the country to improve prenatal care to women covered by Medicaid and CHIP.”

The Strong Start projects are located in 32 states, the District of Columbia and Puerto Rico, and they will serve more than 80,000 women enrolled in Medicaid or CHIP over the three intervention years.

This initiative is a joint effort between the CMS, the Health Resources and Services Administration (HRSA) and the Administration on Children and Families (ACF). It is also supported by various programs across the multiple agencies of HHS. The CMS Innovation Center will administer these awards over four years through cooperative agreements.

Following hip fracture increases after a reduction in reimbursement rates for DXA scans led to fewer scans, a UAB physician joined other advocates and successfully lobbied to increase DXA scan reimbursements to better identify and reduce hip fractures.

A new national, multisite study, chaired by a UAB pulmonologist, shows that supplemental oxygen does not reduce mortality or hospitalization for COPD patients with moderately low levels of blood oxygen.